New Report: 340B Cancer Hospitals More Likely to Pursue Aggressive Medical Debt Collection
Washington, DC – A new analysis from the National Consumers League (NCL) finds that hospitals participating in the federal 340B Drug Pricing Program—including many hospitals that treat high volumes of cancer patients —are more likely than non-340B hospitals to permit aggressive medical debt collection practices such as lawsuits, wage garnishment, liens, and credit reporting.
The data show that 75% of 340B hospitals allow legal action against patients, compared with 62% of non-340B hospitals.
“Our report highlights a troubling reality for Americans facing cancer,” said Lisa Bercu, NCL’s Senior Director of Health Policy. “Hospitals meant to support vulnerable patients are, in many cases, pursuing legal action against them. No one should be forced to choose between survival and financial ruin.”
Medical debt is widespread and damaging. Nearly half of U.S. adults report having medical debt, and cancer patients with debt are three times more likely to delay recommended screenings—jeopardizing their health outcomes.
“After cancer treatment, I drained savings, used work bonuses, launched a GoFundMe, and withdrew from my 401(k),” said Dr. Garrina Ross, metastatic breast cancer thriver and Tigerlily ANGEL Advocate. “Bills went to collections, damaged my credit, and made it difficult to secure housing. Patients should not face financial devastation while hospitals benefit from federal drug discounts tied to their care.”
The analysis reviewed 2,500 hospitals nationwide using data from the Lown Institute, CMS, HRSA, and national claims databases. Among hospitals treating the highest volumes of cancer patients (top 10% nationally), 340B hospitals were consistently more likely than non-340B hospitals to maintain policies permitting aggressive debt collection.
“These findings raise serious questions about whether 340B savings are consistently reaching the patients the program was designed to protect,” Bercu added. “Patients with cancer should not face lawsuits and wage garnishment while hospitals benefit from federal drug discounts.”
As policymakers debate the future of the 340B program, NCL urges stronger accountability measures to ensure patients meaningfully benefit from the program and that hospitals receiving drug discounts do not engage in aggressive debt collection against the very patients the program is intended to support.
- Strengthen and enforce charity care requirements for 340B hospitals
- Prohibit aggressive debt practices, including denial of care due to existing medical debt
- Expand financial assistance screening and transparent billing
- Exclude medical debt from credit reporting decisions
- Prohibit transfer of spousal medical debt
- Support Medicaid expansion and federally qualified health centers
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Advance federal and state medical debt relief proposals
